Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $354.81 / $354.81	Facility		$162.18	$354.81	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $85.11 / $128.82	Professional		$74.13	$85.11	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $229.09	Professional		$165.96	$165.96	$229.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $138.04 / $316.23	Facility		$95.50	$138.04	$316.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $117.49 / $154.88	Professional		$112.20	$117.49	$154.88
United Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $64.57	Professional		$44.67	$44.67	$64.57